Two Days Strategic Planning Meet Among Young Msm in Chennai

TWO DAYS STRATEGIC PLANNING MEET AMONG YOUNG MSM IN CHENNAI

13th14th September 2003

A Dissemination Report

Supported by

UNITED NATIONS INTERNATIONAL CHILDREN’S EDUCATION FUND

(UNICEF)

TAMILNADUSTATE AIDS CONTROL SOCIETY

(TNSACS)

Organised by

Indian Community Welfare Organisation

(ICWO)

Plot.No.1369, 18thMain Road, 6th Street, ‘I’ Block, Vallalar Colony,

Anna Nagar West, Chennai – 600 040

Phone: 044- 26184392

CONTENTS

INTRODUCTION

OBJECTIVES OF THE WORKSHOP

ETHICAL COMMITTEE

THE VENUE AND THE MEET

GROUP INTERACTIONS

THE PRIZY EVENING

THE DELIBERATIONS

RECOMMENDATIONS

ANNEXURE

Documentation By

B. RAGUPATHY

INTRODUCTION

On the basis of Kinsey study, the estimated MSM population in Tamil Nadu is around 62000. MSM includes the many different identities such as gay, homosexual, Panthi and Kothi. These identities often refer to sexual practices – a Panthi is a man who penetrates other men while a Kothi is a young man who is penetrated. There are double duckers who do both on conveniences.

But sex between men is highly stigmatized. Men who are penetrated are associated with femininity and are more stigmatizing. The stigma and discrimination shown by the society, forces the community members to lead a very secretive life. Most of the MSM will not come out openly about their sexuality. While a few MSM might accept their sexuality, the majority think that the feelings they have and what they are doing are abnormal and immoral. They cannot share their feelings openly for fear of rejection and approval by the family and the society.

Another truth about MSM in our society is that he does not see MSM as a community but as aberrations from normal behavior and this has caused him to suffer from discriminatory treatment. This leads to the fact that we have to concentrate on behavior in addition to their sexual identity in the context of STIs/HIV/AIDS prevention.

Marriage is a social norm and it is a strong social pressure on MSM to marry and to father children. But still they continue to have sexual relationship with fellowmen. It is obvious, then, half of MSM populations have bisexual behavior and there is a high risk of transmission of HIV through their female partners. They engage in a variety of sexual practices like mutual masturbation, oral intercourse, and anal intercourse.

OBJECTIVES OF THE WORKSHOP

In 1993, an attempt was made in this metro to unite MSM to make them feel on the urgency on their safer sex practices. Since then, a decade has been over with adhoc programes and ICWO has taken up first time the initiative with the support of UNICEFand TNSACS togather MSM to devise a strategic planning for their safer health and life practices.

The two days workshop held on 13th and 14th of September 2003 aimed at

Identifying challenges in practicing safer sex behaviour among young MSM in Chennai and

Identifying challenges in disseminating information of HIV/AIDS to this young MSM.

A preliminary meeting by the organizer ICWO, sponsors and the facilitators along with the members of young MSM community laid the basis for agenda for the workshop. Besides guest lectures by the UNICEF State representative and the prime speaker invitees, the workshop has been designed to interact in-depth among MSM themselves to chalk out their conditions and needs and their priorities. In order to drive home the essentials of these discussions more lively presentations were arranged with the aid of OHP and role plays. Role plays involved many MSM members and committed them in the proceedings.

ETHICAL COMMITTEE

The ethical committee consists of seven members belonging to the community. An ethical code has been developed to maintain confidentiality over the identity of MSM and maximize their participation in developing planning strategies. The Major decisions held by the committee were:

No member / the community be placed as a cause for spread of HIV

No proceedings or activity or event in the meet should in anyway hurt the community members; nor it should harm them and

Any report or press release on the workshop to be made public only after full consultation and concurrence with the ethical committee.

THE VENUE AND THE MEET

It was a pleasant and warm environment at the cool hall of 6th floor of Days Inn Vijay Park, Arumbakkam, Chennai on 13th September 2003. The sunshine through the thin glass of window panels made a vain attempt to make its presence at the hall but the hall is lit with the brightness of young and energetic MSM in hundreds gathering there to feel and talk about themselves and plan their future. Accompanying them at the hall were their peers, guides and friends, learned and experienced resource persons and veterans in the services of the marginalized community.

The occasion was titled

“TWO DAYS STRATEGIC PLANNING MEET FOR YOUNG MSM IN CHENNAI”

THE EVENTS

Theevents started with a welcome address by Mr. Reginald Watts, a communityrepresentative. Mr. A.J.Hariharan, Secretary ICWO introduced the delegates to the chief guest Mr. Tim Schaffter, State Representative, UNICEF of the workshop and other resource persons, their vast experience in the field of HIV/AIDS and MSM community. The primary among the resources persons participated and facilitated the discussions were:

Mr. BakthavachalamMs. Uma Ravikumar

Ms. R.W. Angeline Ms. Monica Joseph

Mr. Ezhil PariMs. Vasumathi

Mr. Reginald WattsMr.Narayanan

Ms.K.Jasmine AngelineMs. Arthi Tarun

Mr.Jude StephenMr.Sekhar

Other dignitaries present at the meet were Ms. Latha Mani, Mr. P. Guganatham, Mr.Muruganantham, Mr. Ragupathy, Samrakshana, Mr. Kumaresan, Ms. Sumathy Jones, Mr. Vedivel, and Ethical Committee members Mr. Nagaraj, Mr. Baskar, Kushbhu, Mr. Vasu, Shanthi, Raju and Mani.

THE GUEST SPEAKERS

Shri. Senthamizhan, Joint Director, TNSACS spoke in brief on behalf of Shri.K.Dheenabandu IAS, member Secretary and Project Director, TNSACS and read out his message. He referred two sentinel survey fields one at Villupuram and other at ICWO, Chennai and requested the participating NGOs to work for the cause of MSM. He also promised to look into the possibilities of TNSACS assisting MSM based on the outcomes of the workshop.

Mr. Tim Schaffter State Representative, UNICEF, the chief guest, first lit the lamp and then delivered his inaugural address. He spoke very briefly but pointedly he made a reference to Australian gay network as a successful model experiment. He also admitted that in country like India, it was not an easy task to mobilize young MSM and addressing their issues wereeven more difficult as there had been a steady inflow of new members every time and new issues and challenges emerging among them.

He saidthat “UNICEF was pleased to join forces with TANSACS to support the meeting as part of its efforts to reach young people with the information they need to protect themselves from HIV, noting that most of the workshop participants were less than 20 years of age”. The chief guest wished success for the strategic planning meeting to arrive at outcomes to frame action plan for the community interventions.

The UNDP consultant at TNSACS, Shri.Bhakthavatsalam stressed first on the needs of MSM recognizing themselves, their status and their relation to the society and then to work to change the views of the society to recognize them.

Mr. Baskaran, outreach worker gave vote of thanks.

GROUP INTERACTIONS

There were six groups formed among the MSM members on random. All the six spread across the meeting hall and discussed six different topics over the two days. On both the days, presentations over these interactions were made attractive and were authentic through OHP presentation and role plays. Based on the theme coverage, two groups that presented their interactions well were awarded cash prizes.

THE GROUPS AND THE DISCUSSION

Day 1: Migration of Danga / DD (Double Decker) / Kothis & Panthis.

Day 2: Condom accessibility, quality of condoms and STD / HIV treatment care.

Day 1:Client’ violence and harassment

Vs Safer Sex behaviour.

Day 2: Commercial circuit and

condom usage

Day 1: Police action and its impact on HIV / AIDS preventive interventions.

Day 2: Casual partners/ steady partners (Lovers / Husbands / Panthis)

The second day deliberations were initiated by young MSM members by recalling their experience on the first day. The emphasis had been on the opportunities given

to them to express their feelings, issues and interests and their gratitude towards the organizers and sponsors in recognizing them as a community to be cared.

R.W. Angeline, Advocate, MadrasHigh court spoke on law and homosexuals. She prefaced her presentation with a strong statement that there was no law to deny the formal homosexual activities but penetration. She pleaded that law did require proof of evidence to punish MSM of their sexual activities but no partner or Panthi would even come forward to accept their sexual activity and it was below his dignity to come to the court as well it was seldom possible for the police to prove it beyond any reasonable doubt. She also stressed on the need for MSM to fight united against them in the court of law.

In his special address to the co-members the veteran Shri. Sekar B, the President of SWAM, Chennai, was very serious about two immediate concerns among the community members.

The lack of will in using condoms

The increasing silent deaths among MSM owing to the HIV infection.

Two other affected MSM members also shared their views on the significance of accepting their HIV status in order to sensitise the community members to practice safer sex and be cautious against infection.

THE PRIZY EVENING

Later, the delegates were sensitized on issues of HIV/AIDS and the need for safe sexual behaviour through a video Film “I CAN, DO YOU”.

A written quiz on the title “Go for GoldContest” was held to make the members understand and test their knowledge on HIV and AIDS. The winners were distributed the prizes.

The afternoon session of the final day witnessed a variety of dance programme by the participant community members.

Shri.Dr.P.Guhanandhan, UNICEF, Consultant at TNSACS, released the first IEC material meant for the community prepared and designed by ICWO. He also distributed the prizes for the winners of dance competition.

The curtain came down with singing national anthem but certainly it had been the beginning of a new effort in bringing young MSM into community intervention.

The workshop has shown several opportunities to the hosts on the variety of issues and designs to take care on MSM community. The interactions among the community members were in-depth and details are minutes. The workshop has highlighted the community’s…….

Sexual practices, their risk environment, their misconceptions

The discrimination against them by the police and the personnel in health.

The discriminating practices by MSM members.

The impact of their sexual practices on their social and economic life.

The needs for training and sensitization programmes for law enforcing agencies.

The necessity of training and counselling programes for MSM in balancing themselves against sexual exploitation and abuse.

THE DELIBERATIONS

MSM members do understand their risk potential and are able to relate their sexual practices to their vulnerable conditions. But such a sense of risk perception needs to be percolated down to each member of the MSM community.

They all know about condoms and its use but they normally avoid using condoms when

Their partner is a little closer to their feelings and personal understanding.

Their partners are handsome.

Threatened by Beelis (rowdies)

Engaged in oral sex

Cleaner sexual organs

Thus, their reliance on condoms relies upon personal appearance and partners closeness to them rather than risk involvement.

MSM feel insecure in jobs due to their sexual behaviour and hence they are compelled to leave their natives and work often in newer environments. As a result, most of them are in casual jobs and have no regular income. Hence, they are resorting to unsafe sex in increasing their earnings. This has led them to fall a prey to local rowdies and are also compelled to unsafe sexual practices in lieu of protection and personal assistance by the panthis. These young men are also often diverted to become alcoholic and drug addicted by their panthis, which further their vulnerability to STIs/ HIV. The mostly dreaded person for them is police and MSM experience both physical and sexual abuse apart from losing their belongings to police. Police used to book them under false cases, threaten them to reveal their sexual identities to their kiths. Young MSM suffer from humiliations and severe beatings at the hands of police. Young MSM refer police simply as their first and foremost enemies and the daylight robbers.

Police does not seem to understand the behaviour of young MSM and the police have taken them to task just because they have condoms or any other related documents or tools for demonstration or communication purposes.

There is discomfort in disclosing sexual identity among MSM to the doctors in case of treatment for STI treatment. They are often forced to reveal their gender expression in order to access treatment.

Most of the health care providers are ignorant and or insensitive to issues related to diverse sexuality groups.

On treatment side also, young MSM experience discrimination by the public health care personnel. MSM are compelled to bring partners if they need any treatment. Besides, they are often compelled to undergo HIV test despite their unwillingness.

RECOMMENDATIONS:

IEC

Effective education and communication to young MSM on avoiding of multiple partners, forceful sex and unsafe sexual practices.

Awareness on correct use of condoms, increased negotiation skills to improve their bargaining power.

Education on the need for partner treatment, at least the steady partners to avoid reinfection.

Education in avoiding discriminating practices against HIV +ve MSM and necessity to provide care and support to them.

In publicity materials by TNSACS/APAC mentions need to be made on MSM behaviours and more number of articles, stories around MSM necessarily be published.

Availability and Accessibility of condoms

Provisions of increased outlets particularly in cruising points.

Supply of gel atleast at the subsidized rates.

Condom distribution needs to be streamlined to avoid over stock and wastages. There are adequate condoms but not optimally distributed.

Training and Sensitisation programes

Training to MSM in developing their negotiation skills to turn their panthis (Bisexual men) to listen to them.

Training on personality development – self confidence and self development programmes for the young MSM to prevent them falling prey to bad habits and become slave to steady partners.

Frequent demonstrations on correct use of condoms and insisting on using condoms even in oral sex.

Training to health professionals and personnel on treating MSM. Sensitising them on the difficulties of MSM bringing partners, their anonymity.

Training police and other law enforcement agencies on HIV/AIDS, MSM behaviour and their vulnerability to STIs/HIV. Sensitising the police personnel on the need for MSM to keep condoms with them and the use of condoms in preventing HIV infection.

Other Recommendations

MSM need to be persuaded in practicing their sex in privacy; avoiding unsafe public places to prevent police harassment.

Enlisting the co-operation of police in preventing false cases, sexual abuses and exploitation by them.

Establishing the rights of MSM as the rights of human beings and developing the spirit of confrontation when violations take place.

Forming federation of MSM Community to resist police violence and establishing legal aid cell for MSM.

UNICEF, TNSACS and other donor agencies to initiate research to identify MSM in different cities and towns in Tamil Nadu.

UNICEF, TNSACS and other donor agencies to support intervention on STIs / HIV / AIDS for identified MSM in different cities & towns in Tamil Nadu.

Issues and problems related to MSM must be recorded carefully and periodic dissemination through print and electronic media.

The trainee doctors or senior doctors need to obtain the consent of the patient before referring to other doctors for further clinical opinion. Otherwise, these young MSM are often used as specimens to exhibit to medicos – a violation of basic human rights.

There is a need for non-judgmental care and development of ethical code for the HCPs and the medical doctors at the clinics or general hospitals.

With Regards,

A.J.Hariharan,